Hamilton

Researchers are evaluating a type 1 hybrid effectiveness-implementation study that uses a quasi-experimental, difference-in-difference design to deliver a social needs screening and navigation program. This program integrates Community Health Workers into community pharmacies located in under-resourced areas of Western New York. The focus is on addressing social needs status through this innovative approach. The intervention involves community pharmacies distributing social needs screening surveys to patients. Based on identified needs, patients are referred to local community-based organizations for support. Participating pharmacies must be enrolled in the Community Pharmacy Enhanced Services Network - NY or be associated with Tops Pharmacies, with the ability to collaborate with partners like Healthelink and Wellconnected. They also need staff trained to run the social determinant of health screening program. Participants will be adults aged 18 years or older who speak English and visit one of the participating pharmacies located within Erie County. Researchers will measure the effectiveness of this program over a 12-month period. The study involves ongoing assessment of patient referrals and navigation through community resources to address social needs, aiming to improve overall social determinants of health in the community.

Researchers are evaluating surgical and minimally invasive treatments for lumbar spinal stenosis (LSS) by comparing Medicare patients who received the MILD procedure against those who had interspinous process decompression (IPD). The study focuses on outcomes such as the rate of harms related to the initial procedure and the frequency of additional surgical or minimally invasive interventions within 24 months after treatment. Enrollment includes patients treated from January 1, 2017, onward, with continuation until the sponsor decides to stop. The MILD procedure involves percutaneous image-guided lumbar decompression, performed under fluoroscopy through a dorsal approach to partially remove tissue and bone at the affected spinal level. The control group receives the IPD procedure for LSS. Both groups are monitored for a 24-month period post-index procedure using Medicare claims data to track reoperations and any harms. Participants contribute data through Medicare claims without needing prior enrollment or consent, as the study is exempt from IRB oversight. Researchers collect and analyze information on procedure-related harms and subsequent interventions over two years. This approach allows evaluation of long-term safety and effectiveness outcomes for patients treated with either MILD or IPD.